Minimum Standards of Competency for Traditional Health Practitioners (THP) in the
management of Poisonous Bites
Sl. No. Awareness (What?)
1.
Knowledge (Why?)
Skills (How?)
Which bites do you
treat?
-Insect bites/sting
(Spider,Bees,Centepede)
-
Scorpion bite
Snake bite
1.1
Insect bite
1.1.1
Contact with body part
/ discharge of insect
1.2.
Bee sting
1.3.
Spider bite
1.4.
Dog/ Rabid Dog bite
1.5.
Cat bite
1.6
Hornet
1.7
Scorpion bite
1.7.1
External medicine
Dog bite-risky (wash the affected area
before applying any medicine/ointment)
Soap nut scoured in water to be applied
on the sting wound
Aak (Calotropis procera) milk to be applied
on the sting wound
Crushed aam manjari (Mengi fera) to be
put on the wound
Imli/Nirmali seeds soured in water and
applied on the sting wound
Salt water drops in nostril and eye
Onion juice applied on the wound
Juice of satyanashi (Argemone mexicana)
to be applied on the sting wound
1.7.2
Medicines
20 ml apamarg (Achyranthus aspera) juice
twice daily
8 gm raw indryan (Citrullus colocynthis)
1
fruit.
250 gms tea of soap nut root powder
Fomentation, bleed letting, venesection,
topical applications, parasurgical
methods
1.8
Snake bite
1.8.1
Venomous snake bites
Green snakes, black
snakes
By rubbing with a special kind of a stone
used for snakebites (mawbsein), fats of
local chicken, tie the affected area tightly
so that it will not affect the whole body
by using a special kind of vine ( traw),
roll the affected part with a thread so that
the teeth will come out
1.8.1.1 King Cobra
1.8.1. 2 Cobra
1.8.1. 3 Vipers
a. Pit viper
b. Little viper
c. Spotted viper
1.8.1.4 Krait
1.8.1. 5 Other venomous snake
bites (specify)
1.8. 2
Non venomous snake
bites
1.8.2.1 Rat snake
1.8.2.2 Wolf snake
1.8.2.3
Water snake
1.8.2.4 Others bites ( Specify)
2.
Signs / Symptoms
2.1
Insect bite/ Sting
2.1.1
Local
2.1.2
Discoloration reddish, blackish, bluish
2.1.3
Pain (mild to severe)
Itching, frequency,
intensity, time,
2
giddiness, blurred
vision, vomiting,
feeble pulse
2.1.4
Burning sensation –
 Frequency –
until medicine
application
 Intensity Severe
2.1.5
Swelling on site of
bite, that can spread
later to other parts
2.1.6
Retained sting mark,
Fever, Breathlessness
2.1.7
Vesicle / papule
2.1.8
Discharge – watery,
slimy, pus / crust
2.1.9
Ulceration
2.1.10
Others (Specify)
2.2
Systemic (Insects)
2.2.1
High fever for a day or
two
2.2.2
Body pain
2.2.3
Thirst
2.2.4
Burning sensation
2.2.5
Breathlessness
2.2.6
Diarrhoea, Vomitting,
Loss of Consciousness
Others (Specify)
2.3
Spider bite
2.3.1
Systemic - Local


Reddish blue
discoloration
Swelling at the
site of bite
which spreads
3

to other parts
Burning
sensation
Pain



Fever
Body Pain
Thirst

2.3.2
Systemic
2.4
Snake bite (Specify)
2.4.1
Local
2.4.1.1
Fang / teeth marks
2.4. 1.2
Severe pain
2.4. 1.3
Burning & iching
2.4. 1.4
Discolouration
2.4. 1.5
Swelling, giddiness &
palpitation
2.4. 1.6
Redness
2.4. 1.7
Rise in temperature &
reduced hearing
ability
2.4. 1.8
Cramps
2.4. 1.9
Ulceration & necrosis(Greenish discharge)
2.4.2
Systemic (Snake)
2.4.2.1
Unconsciousness,
convulsion
2.4.2.2
Breathlessness
2.4.2.3
Hematuria
2.4.2.4
Salivation & dribbling
of saliva
2.4.2.5
Muscle weakness &
difficulty in
swallowing
4
2.4.2.6
Abdominal pain
2.4.2.7
Thirst
2.4.2.13
Others ( Specify)
3.
Diagnostic Procedures
3.1
Based on clinical
manifestation
3.2
Based the features
described by the
messenger who
informs about the
victim
3.3
Others ( specify)
4.
 If the snake is poisonous, there
develops a black spot where that
snake bites
 If there are two deep spots on the
place of bite then it is not
poisonous
 Based on the taste experienced
from oral medication (chew and
spit out).
 If the patient finds the neem
leaves (Azadira Indica)and red
chilli hot on eating them the snake
is not poisonous but if the patient
finds it sweet then the bite is
poisonous.
Prognosis
4.1
-Easy to cure
( Specify the type –
symptom and other
factors)
-Habits of the patients
including pan,
smoking etc
-Under the influence
of narcotics
4.2
In such cases do you
refer the patient? If yes,
to whom?
5
Treatment
5.1
Specify Insect/ Snake




More than 2 daysDifficult to cure
Impossible to cure
Patient will not survive
Refer to an expert if available / nearest
PHC / hospital
 Tie a tourniquet above the site of
5
bite/ Others
the bite
 Coralocarpus epigeus paste to be
applied at the site of the bite
 Aak milk Calotropis procera milk
and salt to be put on the site of the
bite
 Red onion juice and white alum
should be tied on the site of the
bite
5.2
Oral medication
 7 peepal Ficus religiosa leaves, 150
gm ghee, 2 black pepper (Piper
nigrum) paste
 By chewing Babool (Acacia
fernesiana) leaves poison does not
spread
 2 leaves of tobacco (Lobelia inflate),
1 gm powder of black shirish
(Albezzia lebbeck) bark with water
 25 ml juice of basil (Ocimum
sanctum)
 10-20 gm powder of rakt
punarnava (Boerhavia diffusa) root
 50 gm powder of ankol root
(Allangium salvifoluim)
 Leucas aspera juice in nose and eyes
 Nasya of powder of soap nut
(Sapindus mukorossi)
5.2.1
Single drug - herb/
mineral/ others to
specify
 Approximately 50 ml juice of fresh
Kasmarda (Cassia occidentalis)
leaves
 Seeds of morpankhi (Actiniopteris
radiate) for smelling
 Tea of powder of ankol bark
(Allangium salvifolium), 7 black
pepper, 12 basil leaves
5.2.2
Poly herbal
5.2.3
Herbal with fats of
local chicken
6.
Dosage form
Ghee, oils, decoction
 Prepare as decoction by grinding
6
broomgrass, garlic, traw and some
medicinal plants
 Bandage the affected part by grinding
ginger, tobacco, leaves of some vine
trees and tuber of sohlakot herbs
 Apply as ointment from the fats of
local chicken
7.
Adult, children
specifically and
expectant mothers
Adult 3-4 tsp
Child 1 tsp
Expectant mother 1-2 tsp
7.1
Time of intake
Morning, day and evening
7.2
Number of times a
day
3-4 times a day
8
Dosage
External medicine
8.1
Fomentation
8.2
Others ( Specify)
8.3
Bleed letting by a traw (kind of vine)
8.4.
Chilli mix with lime, lemon and tobacco
9.0
When applied (Signs /
symptoms)
9.1
How applied
9.2
Prepared by healer
9.3
Prepared by recipient
9.4
Follow up visit needed.
If so, specify.
Break the imli fruits into two parts and
attatch the white portion of imli into the
affected part. If the imli sticks, it shows
the snake poison is still there
7